ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2015
Chest pain for coronary heart disease in general practice: clinical judgement and a clinical decision rule.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Chest discomfort at night and risk of acute coronary syndrome: cross-sectional study of telephone conversations.Family practice · 2020Trial
- The HEART-GP strategy for ruling out acute coronary syndrome in out-of-hours primary care: a diagnostic accuracy trial protocol.Contemporary clinical trials communications · 2026Article
- Evaluating the Efficacy of the Marburg Heart Score to Triage Patients Presenting With Chest Pain in an Emergency Department: A Prospective, Multicenter, Observational Study.Emergency medicine international · 2025Article
- Improving event prediction using general practitioner clinical judgement in a digital risk stratification model: a pilot study.BMC medical informatics and decision making · 2024Article
- Article
- Article
- Article
- Recent developments in diagnosis and risk stratification of non-ST-elevation acute coronary syndrome.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020Review
- Observational
- A Nationwide Flash-Mob Study for Suspected Acute Coronary Syndrome.Annals of family medicine · 2019Observational
- The conundrum of acute chest pain in general practice: a nationwide survey in The Netherlands.BJGP open · 2018Article
- Prognosis of undiagnosed chest pain: linked electronic health record cohort study.BMJ (Clinical research ed.) · 2017Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Marburg Heart Score (MHS) is a simple, valid, and robust clinical decision rule assisting GPs in ruling out coronary heart disease (CHD) in patients presenting with chest pain.
aimTo investigate whether using the rule adds to the GP's clinical judgement. DESIGN AND
settingA comparative diagnostic accuracy study was conducted using data from 832 consecutive patients with chest pain in general practice.
methodThree diagnostic strategies were defined using the MHS: diagnosis based solely on the MHS; using the MHS as a triage test; and GP's clinical judgement aided by the MHS. Their accuracy was compared with the GPs' unaided clinical judgement.
resultsSensitivity and specificity of the GPs' unaided clinical judgement was 82.9% (95% confidence interval [CI] = 72.4 to 89.9) and 61.0% (95% CI = 56.7 to 65.2), respectively. In comparison, the sensitivity of the MHS was higher (difference 8.5%, 95% CI = -2.4 to 19.6) and the specificity was similar (difference -0.4%, 95% CI = -5.3 to 4.5); the sensitivity of the triage was similar (difference -1.5%, 95% CI = -9.8 to 7.0) and the specificity was higher (difference 11.6%, 95% CI = 7.8 to 15.4); and both the sensitivity and specificity of the aided clinical judgement were higher (difference 8.0%, 95% CI = -6.9 to 23.0 and 5.8%, 95% CI = -1.6 to 13.2, respectively).
conclusionUsing the Marburg Heart Score for initial triage can improve the clinical diagnosis of CHD in general practice.
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